ASSESSING KNOWLEDGE, ATTITUDES, AND PRACTICES OF HEALTHCARE PROFESSIONALS REGARDING HOSPITAL ACQUIRED INFECTION IN TERTIARY CARE TEACHING HOSPITAL AT EASTERN NEPAL: CROSS-SECTIONAL STUDY

Hospital-acquired infections (HAIs) are a common problem and represent significant challenges to the effective delivery of healthcare services faced by hospitals in all countries around the world. Healthcare workers (HCWs) are an important part of the healthcare team that plays a unique role in the control of HAIs. Compliance on the part of healthcare workers (HCWs) with standard precautions has been recognized as being an efficient means to prevent and control HAIs. Objective: The present study was conducted with objective of understanding the level of Knowledge, attitude and practice (KAP) regarding Hospital-acquired infections (HAIs) among health care workers in the Eastern region of Nepal. Method:This descriptive cross-sectional study was conducted among healthcare workers posted in different wards of hospitals of BPKIHS. A self administered questionnaire containing different set of questions regarding knowledge, attitude and practice on HAI were used for data collection. Simple random sampling method was employed. Statistical package for social sciences (SPSS) was used to analyze the data and presented in frequency tables and graph. Results: Regarding knowledge of the participants: Among the total participants in the study, 97% of the participants had good knowledge regarding Hospital acquired infections (HAIs) but only 72% of the participants had received formal training regarding hand hygiene. 97 % participants agreed on the fact that hand hygiene act should be performed before and after direct patient contact. Highest proportions of the participants (97%) were aware of the fact that washing hands with antiseptic decreases the risk of transmission of hospital acquired pathogens. Large proportion of the respondents ( 95%) were aware of the fact that Gloves should be worn if blood or body fluid exposure is anticipated and still considered that gloves provided complete protection against acquiring/ transmitting infections. Hand hygiene (89%) and Personal protective equipment 68%) were common preventive measures of transmission of hospital acquired infection. The common sources of acquiring infections was uniform (59%) whereas commonly hospital acquired infection (HAIs) were reproductive tract infection (86%) and gastro -intestinal tract (GIT) infection (76%) and most susceptible group to hospital acquired infections (HAIs) were OT assistants (74%), Lab technicians(69%) etc. Regarding attitude of the participants, 91% of the participants felt that they would be less likely to transmit infection to the patient if they performed hand-hygiene. Regarding various hindrances in adoption of hand hygiene, few of the respondents (48%) identified that hand hygiene agents were not readily available in our current settings. 31% of the health care workers reported that they often forgot to perform hand hygiene.42% of health care workers found that Gloves are always available when they wanted. 25% of health workers believed that there was very low risk of acquiring infections from my patients.79 % participants thought that all patients are potentially contagious while 88% transmission of hospital acquired infections occurred through unsterilized use of needles and sharp objects. Regarding practice of the participants , majority of respondents (more than 90%) performed hand hygiene before patient contact, after patient contact and caring for wound.95% of the participants practiced hand hygiene after removal of gloves. Majority of the participants (97%) washed their hands after handling every patient. 74% participants practiced of using reusable instruments while 86% respondents practiced of using pre-sterilized instruments. 82 % of the participants exposed to patients blood. Conclusion: All health workers had good knowledge regarding Hospital-acquired infections (HAIs) that was reflected in their attitude and practice on hand hygiene for the prevention of HAIs. However there is the need of regular training and performance feedback regarding hand hygiene and the hospital environment should be hand-hygiene friendly with easily accessible to sinks and other facilities. Improving sustainable supplies like personal protective equipment, water supply and hand washing facilities at patient care site is vital to reduce nosocomial infection. Therefore health workers should strictly follow hospital acquired infection prevention guidelines to reduce infections